Botulinum Toxin Application
|
|
- Allen Cox
- 5 years ago
- Views:
Transcription
1 Botulinum Toxin Application
2 Clostridium botulinum: rod-shaped bacterium producing the neurotoxin botulin Gram-positive anaerobic bacterium Seven serotypes - A, B, C, D, E, F, G
3 Structure of Botulinum Toxin Heavy chain: ~ N-terminal end ~ 100 kd ~ binds to botulinum toxin reeceptors on the surface of axon terminals, the botulinum toxin can be taken into neurons by endocytosis. Light Chain: ~ N-terminal end ~ 50 kd ~ a zinc (Zn 2+ ) endopeptidase ~ attacks one of the fusion proteins (SNAP-25, syntaxin or synaptobrevin) SNARE: SNAP (Soluble NSF Attachment Protein) REceptor") proteins
4 Botulinum Toxin Mechanism Heavy chain Light Chain:
5 A specific inhibitory activity of Botulinum Toxin Presynaptic cell Internalisation Dissociation of Botulinum Toxin Return of neuromuscular functions by axonal sprouting Inhibition
6 Botulinum Toxin Products Dysport Botox Name AbotulinumtoxinA (ABO) OnabotulinumtoxinA (ONA) Strain Hall strain of Clostridium botulinum type A Hall strain of Clostridium botulinum type A Purification Column separation Dialysis and acid precipitations Ranoux et al., J Neurol Neurosurg Psychiatry 2002; 72: Odergren et al., J Neurol Neurosurg Psychiatry 1998; 64: 6-12 Carr et al., Arch Dis Child 1998; 79:
7 Applications of Botulinum Toxin Upper facial wrinkles Glabellar lines/frown Lines Forehead wrinkles Crow s feet Lateral eyebrow lift/ Brow shaping
8 Applications of Botulinum Toxin lower face Middle and lower face, neck and chest neck Lower eyelid wrinkles Bunny lines Drooping nasal tip Perioral wrinkles Masseter hypertrophy Drooping mouth corners/ Marionette Lines Dimpled chin Platysmal bands/ Turkey neck
9 Applications of Botulinum Toxin Calf Hyperhidrosis Face Lifting
10 Glabellar lines (Frown Lines) Mid-pupillary lines Dose per injection point No. injection points Total dose Injection site 10 U/point 5 points (1 point in the procerus and 2 points in each corrugator) 50 U (Recommended dose range: 30-70U.) 0.5 to 1 cm from the upper orbital rim and internal to the mid-pupillary lines 9-15,18 Upper orbital rim line Injection technique Safety concerns Deep intramuscular and perpendicular injections to the last third of a 30G needle Headache and injection site reactions (most frequently reported AE) Eyelid ptosis, subsides within a few weeks. J Eur Acad Dermatol Venereol Nov;24(11):
11 Glabellar lines (Frown Lines) 50 U Botulinum Toxin 30 days J Eur Acad Dermatol Venereol Nov;24(11):
12 Forehead Lines Mid-pupillary lines Dose per injection point No. injection points Total dose Injection site Injection technique 5-10 U/point 4 to 6 points s.u -In the forehead below the hairline ( 4 5 cm from the orbital rim) In a slightly curved V- shape in women and straight in men if applicable Lateral points on the external orbital rim lines Superficial intramuscular and perpendicular injections to the middle third of an 30G needle Upper orbital rim line Safety concerns -To avoid brow ptosis, prefer injection points in the upper 2/3 of the forehead. - To avoid wrinkle formation above the lateral part of the eyebrows, assess carefully the position of the eyebrows before treatment, and place the lateral points on the external orbital rim lines J Eur Acad Dermatol Venereol Nov;24(11): * It is recommended to first start with a small dose to avoid a frozen look, as the frontalis is a low-dose reactive muscle. ** Highly recommended especially for less experienced injectors.
13 Forehead Lines 40 U Botulinum Toxin 30 days J Eur Acad Dermatol Venereol Nov;24(11):
14 Crow s Feet Dose per injection point No. injection points 5-10 U/point 6 points in total, i.e. 3 per side Total dose U,i.e U/side * External orbital rims Injection site Injection technique Safety concerns All points at the external part of the orbicularis oculi and about 1-2 cm from the external orbital rim Lateral injections (20-30 angle to the skin, away from the patient s eyes, by be placed at the opposite to the treatment side) and superficial to the first 1/3 of the needle Use optimal lighting and stretch the skin slightly to avoid injecting into blood vessels -Should have a positive snap test and preferably good skin elasticity -Should NOT have dry eyes, prominent eye bags, scleral show or morning eyelid oedema -Mild periorbital haematoma (most frequently reported AE) Injection points J Eur Acad Dermatol Venereol Nov;24(11):
15 Crow s Feet 30 U Botulinum Toxin 30 days J Eur Acad Dermatol Venereol Nov;24(11):
16 Lateral eyebrow lift (Brow shaping) Mid-pupillary lines Upper orbital rim line Dose per injection point No. injection points Total dose Injection site Injection technique Safety concerns 5 10 U/point 2 per side, 4 points in total U in total, i.e U/side -1 injection point should be placed at each eyebrow tail into the pars orbicularis, 2 additional injection points placed at the external part of the frontalis, slightly more internal than the orbicularis points Superficial intramuscular injections and perpendicular to the skin, to the middle third of the needle Rare eyelid and brow ptosis (when the injection volume is too large or when the injection sites are too close to the orbital rim. J Eur Acad Dermatol Venereol Nov;24(11):
17 Lateral eyebrow lift (Brow shaping) 20 U Botulinum Toxin 7 days J Eur Acad Dermatol Venereol Nov;24(11):
18 Lower eyelid wrinkle Dose per injection point No. injection points Total dose Injection site Injection technique Safety concerns U/point 1-2 point/side, 2-4 points in total 5 U in total, i.e. 2.5 U/side 1 2 injections at the mid-pupillary line, about 2 mm below the border of the lower eyelids Injection should be very superficial Patient selection is crucial for this indication. Injectors should avoid patients having dry eyes, prominent eye bags, scleral scleral show or morning eyelid oedema. In addition, patients need to have a positive snap test and preferably good skin elasticity. J Eur Acad Dermatol Venereol Nov;24(11): TWTW426&biw=1024&bih=503&tbm=isch&tbnid=HXlqxDSKwSWDEM:&imgrefurl=
19 Lower eyelid wrinkle 6 U Botulinum Toxin 15 days J Eur Acad Dermatol Venereol Nov;24(11):
20 Bunny lines Dose per injection point No. injection points Total dose Injection site Injection technique 5-10U/point 1 point/per side, 2 points in total 10-20U in total 1 cm above the upper lateral part of the nostril The injection should be very superficial to, avoiding contact with blood vessels or periosteum. The orientation of the injection should be perpendicular, with an angle of about 45 to the nasal bone. J Eur Acad Dermatol Venereol Nov;24(11):
21 Bunny lines 30 U Botulinum Toxin 21 days J Eur Acad Dermatol Venereol Nov;24(11):
22 Perioral wrinkles Dose per injection point No. injection points Total dose 1-2U/point the upper lip: 4-6 points, symmetrical the lower lip : 2 points 4-12U in total Injection site The lateral points should be at least 1.5 cm away from the mouth corners, at the cross points of the lip vermilion border and vertical lines extended from the external ala. The medial points: 1 mm away from the philtrum. Injection technique Safety concerns Injection should be perpendicular to the skin and superficially intramuscular, to the first third of the needle. The lateral points should be sufficiently far away from the mouth corners, to avoid possible adverse events such as mouth asymmetry, drooping mouth corners and drooling J Eur Acad Dermatol Venereol Nov;24(11):
23 Perioral wrinkles 12 U Botulinum Toxin 21 days J Eur Acad Dermatol Venereol Nov;24(11):
24 Masseter hypertrophy x Masseter x x x Dose per injection point No. injection points Total dose Injection site Injection technique Safety concerns 10-20U/point 3 points /side, total 6 points 120U for Asians, 60 for Caucasians The injection points should be below the ear lobe mouth corner line and about 1.5 cm above the mandibular angle border. Injection should be perpendicular to the skin and intramuscular, to the middle third of the needle. In some cases, the masticating capability might also be reduced ( start with a smaller dose). Injection just beneath the zygomatic bone should be avoided as it may impair the function of zygomatic muscles, resulting in awkward facial expression especially when smiling. J Eur Acad Dermatol Venereol Nov;24(11):
25 Square Face Masseter Dose per injection point No. injection points Total dose Injection site 25U/point 4-5 points/side U/side The injection points should be below the ear lobe mouth corner line and about 1.5 cm above the mandibular angle border. x x x x x
26 Marionette Lines (Drooping mouth corner) J Eur Acad Dermatol Venereol Nov;24(11): Dose per injection point No. injection points Total dose Injection site Injection technique Safety concerns 5-10U/point 1 point/per side, total 2 points 10-20U in total -The injection points should be slightly internal to the cross points of the extension of the nasolabial fold and the jaw line. -The muscle location can be verified by asking the patients to grind their teeth or to grimace. The injector should pinch the muscle slightly to prevent its movement and inject intramuscularly and perpendicularly, to the middle third of the needle. When the injection dose is too high or when injection points are too close to the mouth corners, resulting in adverse events such as drooling, speech impairment and mouth asymmetry (start with a minimal dose volume and far away from the mouth corners).
27 Marionette Lines (Drooping mouth corner) 20 U Botulinum Toxin 21 days J Eur Acad Dermatol Venereol Nov;24(11):
28 Dimpled Chin Dose per injection point No. injection points Total dose Injection site Injection technique Safety concerns 5-10U/point 2 points 10-20U in total A two-point injection at the bony jaw line close to the centre. The injector can identify the points by asking the patient to try to reach his her nose with the lower lip. The needle should be perpendicular to the skin, and injection should be superficial, intramuscular to the middle third of the needle. Injecting a higher than recommended dose or injecting close to the lower lip may affect the depressor labii inferioris and the orbicularis oris, causing drooling, speech impairment, mouth asymmetry and lower lip ptosis. J Eur Acad Dermatol Venereol Nov;24(11):
29 Dimpled Chin 14 U Botulinum Toxin 21 days J Eur Acad Dermatol Venereol Nov;24(11):
30 Platysma folds (Turkey neck) J Eur Acad Dermatol Venereol Nov;24(11): Dose per injection point No. injection points Total dose Injection site Injection technique Safety concerns 5-10U/point Depends on the number and length of platysma bands. Max dose: 50U/side It is recommended that injectors start the first point at the jaw line, and go down every 2 cm to at least the middle of the bands The injector can examine the prominence of platysmal bands by asking the patients to pronounce the letter E. Once the platysmal bands become apparent, the injector should slightly pinch it, pull it away and inject horizontally on the band with a superficially intramuscular injection. Although dysphagia, dysphonia and neck weakness were listed as potential serious adverse events, they were results of extremely high dose or very deep injection of botulinum toxin.
31 Platysma folds (Turkey neck) 120 U Botulinum Toxin 13 days J Eur Acad Dermatol Venereol Nov;24(11):
32 Hyperhidrosis Expert Review of Dermatology 5.1 (Feb 2010): p31 32
33 Axillary hyperhidrosis Iodine-Starch test. Injection points: -about 15 sites/each side Injection dosage: 10U/point Botulinum Toxin (0.05cc/point) Nerve block
34 Iodine-Starch test. Use a surgical pen and standard ruler to mark injection points 1.5 to 2 cm apart and staggered. Count injection points and allocate recommended dosage of Botulinum Toxin solution per injection. Inject to a depth of approximately 2 mm and at a 45 angle to skin surface with bevel side up. Be sure not to inject directly on ink mark to avoid a permanent tattoo effect. After injection, clean treated area with alcohol.
35 Palmar hyperhidrosis Injection points: -16 ~ 30 sites for the palm Nerve block -14 ~ 16 sites for fingers Injection dosage: -5 ~ 8 U/point Botulinum Toxin (0.025 cc/point)
36 Contraindication Known hypersensitivity to any component of Botulinum Toxin generalized disorders of muscle activities usage of aminoglycoside antibiotics. pregnancy
37 Thanks for your attention
ORIGINAL ARTICLE. Keywords Botulinum toxin type A, consensus, facial wrinkles, Speywood
DOI: 10.1111/j.1468-3083.2010.03728.x JEADV ORIGINAL ARTICLE International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) part II: wrinkles on the middle and
More informationPRE- READING COURSE MATERIAL ADVANCED BOTOX Module 2
PRE- READING COURSE MATERIAL ADVANCED BOTOX Module 2 Unit Overview Storage and shelf-life Cautions and contra-indications of treatment Reconstitution The treatment process Cosmetic indications for use
More informationINSTRUCTIONS INTRODUCTION RISKS OF BOTULINUM TOXIN / DERMAL FILLER INJECTIONS
INSTRUCTIONS This is an informed consent document that has been prepared to help inform you concerning botulinum toxin / dermal filler injections and the risks involved. It is important that you read this
More informationBotulinum Neuromodulators: The Basics. Karol A Gutowski, MD, FACS
Botulinum Neuromodulators: The Basics Karol A Gutowski, MD, FACS Disclosures AxcelRx Pharmacuticals - Advisory Board Suneva Medical - Instructor Will discuss off-label uses Will use brand names for ease
More informationDr. F Didar CEO Cosmetic Facial UK(CFUK) Limited
Dr. F Didar CEO Cosmetic Facial UK(CFUK) Limited www.cosmeticfacial.co.uk, info@cosmeticfacial.co.uk 1. 1895:professor Emile Pierre Van Ermengem discovered(identified) bacterium bacillus botulinum. It
More informationBotulinum Neuromodulators: Clinical Uses. Karol A Gutowski, MD, FACS
Botulinum Neuromodulators: Clinical Uses Karol A Gutowski, MD, FACS Disclosures Angiotech/Surgical Specialties - Advisory Board AxcelRx Pharmacuticals - Advisory Board Suneva Medical - Instructor Will
More informationHead and Face Anatomy
Head and Face Anatomy Epicranial region The Scalp The soft tissue that covers the vault of skull. Extends from supraorbital margin to superior nuchal line. Layers of the scalp S C A L P = skin = connective
More informationFrequently Asked Questions
Frequently Asked Questions What are the causes of wrinkles and facial expression lines? As noted above, lines and wrinkles develop, at least in part, from the action of facial muscles under the skin. After
More informationBotulinum toxin: Getting started with cosmetic treatment Learning Objectives The Aging Face The Aging Face The Aging Face
1 2 Botulinum toxin: Getting started with cosmetic treatment Suzanne K. Freitag, M.D. Director, Ophthalmic Plastic Surgery Service Massachusetts Eye and Ear Infirmary Harvard Medical School 3 I have no
More informationConsensus Recommendations on the Aesthetic Usage of Botulinum Toxin Type A in Asians
Consensus Recommendations on the Aesthetic Usage of Botulinum Toxin Type A in Asians BONG KYUN AHN, MD,* YOUN SUNG KIM, MD, HONG JIG KIM, MD, NARK KYOUNG RHO, MD, AND HEI SUNG KIM, MD BACKGROUND The use
More informationMuscles of the Face, Head, and Neck
Muscles of the Face, Head, and Neck 1 How Muscles Are Named Many muscles named using such features as Location Function Shape Direction of fibers Number of heads or divisions Points of attachment Size
More informationClare Gaduzo BSc RMN Registered Aesthetics Practitioner (qualified with Medics Direct)
Clare Gaduzo BSc RMN Registered Aesthetics Practitioner (qualified with Medics Direct) 07935567067 cjg.aesthetics@yahoo.co.uk www.cjgaesthetics.co.uk http://www.facebook.com/cjgaesthetics @CJGAesthetics
More informationSierra Smith Bio 205 Extra Credit Essay. My Face. Growing up I was always told that it takes 43 muscles to frown but only 17
Sierra Smith Bio 205 Extra Credit Essay My Face Growing up I was always told that it takes 43 muscles to frown but only 17 muscles to smile and I should just smile because it's easier. It wasn't until
More informationOverview of Botulinum Toxin
Chapter 1 Overview of Botulinum Toxin Berthold Rzany, Hendrik Zielke 1 Contents 1.1 Introduction............. 1 1.2 Different Subtypes of Botulinum Toxin. 1 1.3 Mode of Action............ 1 1.4 Antidote...............
More informationBOTOX Cosmetic (onabotulinumtoxina) before-and-after
BOTOX Cosmetic (onabotulinumtoxina) before-and-after Moderate to severe crow s feet lines Before After (Day 7) Actual patient. Results may vary. Photos taken at full smile before and after treatment with
More information3-Deep fascia: is absent (except over the parotid gland & buccopharngeal fascia covering the buccinator muscle)
The Face 1-Skin of the Face The skin of the face is: Elastic Vascular (bleed profusely however heal rapidly) Rich in sweat and sebaceous glands (can cause acne in adults) It is connected to the underlying
More informationThe Scalp and Face Protocol. Julie Goodwin, BA, LMT
The Scalp and Face Protocol Julie Goodwin, BA, LMT The Scalp and Face Protocol Julie Goodwin, BA, LMT Julie Goodwin 2014 2 Agenda Pertinent Anatomy and Physiology Treatment Planning Strokes, Techniques
More informationBOTOX Cosmetic (onabotulinumtoxina) before-and-after photo files
BOTOX Cosmetic (onabotulinumtoxina) before-and-after photo files INSTRUCTIONS FOR USE This zip file contains PDF files with images and Important Safety Information to copy and paste into your practice
More informationDisclaimer. All information shared in this presentation is in the public domain.
THE BOTOX STORY Disclaimer All information shared in this presentation is in the public domain. Hence, no trade secret related to drug formulation, manufacturing process, commercial practice, etc. The
More informationEvaluation of the patient for cosmetic Botox injections
Facial Plast Surg Clin N Am 11 (2003) 349 358 Evaluation of the patient for cosmetic Botox injections Steven H. Dayan, MD, FACS*, Benjamin A. Bassichis, MD Department of Otolaryngology, Division of Facial
More informationInternational consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) part I: upper facial wrinkles
DOI: 10.1111/j.1468-3083.2010.03631.x JEADV ORIGINAL ARTICLE International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit) part I: upper facial wrinkles B Ascher,,
More informationPlease see Approved Uses and Important Safety Information, including Boxed Warning, inside.
Please see Approved Uses and Important Safety Information, including Boxed Warning, inside. IT S YOUR STORY, TELL IT YOUR WAY You ve probably heard of BOTOX Cosmetic, but did you know: It s the first and
More informationFacial Accupressure Massage. Taha Haque, D.O. CAM Workshop
Facial Accupressure Massage Taha Haque, D.O. CAM Workshop 1 10July2015 Benefits of facial accupressure Enhance local blood flow Firm and tone face and neck Mild to moderate symptomatic relief of headaches,
More informationSpaMedica Botox Injection Techniques
SpaMedica Botox Injection Techniques You have diluted the 100 units of Botox with the 2 cc of preservative free normal saline and have drawn up 6 syringes of Botox, each with 15 units of BTX A. Each incremental
More informationFace. Definition: The area between the two ears and from the chin to the eye brows. The muscles of the face
Face Definition: The area between the two ears and from the chin to the eye brows. The muscles of the face The muscle of facial expression (include the muscle of the face and the scalp). All are derived
More informationP atients seeking facial rejuvenation
By Hema Sundaram, MD A Practical Primer For Dysport, Part 2: Strategies for Success with the Periorbital Frame and Special Considerations for Skin of Color Comprehensive patient assessment, a thorough
More informationThe Effect of Periorbital Botox Injection on the Eye
Kasr El Aini Journal of Surgery VOL., 11, NO 3 September 2010 61 The Effect of Periorbital Botox Injection on the Eye HishamM.El-Minawi M.D.* and Malak I. ElShazly M.D.**AmiraA.Zayed*** Department of Plastic
More informationBotox , The Patient Education Institute, Inc. rxf60101 Last reviewed: 01/11/2018 1
Botox Introduction Botox is a well known brand name for a medicinal form of a toxin, or poison. When injected in small doses into specific muscles, Botox doesn't poison you. Instead, it acts as a muscle
More informationIntroduction. Images supplied. SUBJECT IMAGES (Victor Vinnetou) TARGET IMAGES (Mbuyisa Makhubu)
Victor Vinnetou and Mbuyisa Makhubu facial comparison case, compiled by Dr T Houlton, School of Anatomical Sciences, University of the Witwatersrand (3 June 2016) Introduction There currently exists an
More informationThis lab activity is aligned with Visible Body s Anatomy and Physiology app. Learn more at visiblebody.com/professors
1 This lab activity is aligned with Visible Body s Anatomy and Physiology app. Learn more at visiblebody.com/professors 2 PRE-LAB EXERCISES A. Watch the video 13.1 Muscular System Overview and observe
More informationTo successfully perform any facial injection,
INJECTABLES Newer Understanding of Specific Anatomic Targets in the Aging Face as Applied to Injectables: Facial Muscles Identifying Optimal Targets for Neuromodulators Jonathan M. Sykes, MD Patrick Trevidic,
More informationBotox pearls, perils, and pitfalls. Patient comfort. Patient comfort. Higher doses give longer results. Botox (onabotulinumtoxina) starting doses
Botox pearls, perils, and pitfalls Ronald L. Moy, M.D, Beverly Hills, CA No financial conflicts of interests. Botox before Botox after Risks, rewards, happy, unhappy- higher doses, fewer injection sites,
More information3. The Jaw and Related Structures
Overview and objectives of this dissection 3. The Jaw and Related Structures The goal of this dissection is to observe the muscles of jaw raising. You will also have the opportunity to observe several
More informationORIGINAL ARTICLE. Electromyographic Differences Between Normal Upper and Lower Facial Muscles and the Influence of Onabotulinum Toxin A
ORIGINAL ARTICLE Electromyographic Differences Between Normal Upper and Lower Facial Muscles and the Influence of Onabotulinum Toxin A Bryan J. Winn, MD; Bryan S. Sires, MD, PhD Importance: Empirically
More informationKevin T. Kavanagh, MD
Kevin T. Kavanagh, MD Axial Based upon a named artery. Survival length depends upon the artery not the width of the flap. Random Has random unnamed vessels supplying it. Survival length is directly proportional
More informationPH-04A: Clinical Photography Production Checklist With A Small Camera
PH-04A: Clinical Photography Production Checklist With A Small Camera Operator Name Total 0-49, Passing 39 Your Score Patient Name Date of Series Instructions: Evaluate your Series of photographs first.
More informationCrow's Feet Treatment with Botulinum Toxin Type A. I Petropoulos, G Noussios, P Chouridis, G Kontzoglou, K Karagiannidis
ISPUB.COM The Internet Journal of Aesthetic and Antiaging Medicine Volume 1 Number 2 Crow's Feet Treatment with Botulinum Toxin Type A I Petropoulos, G Noussios, P Chouridis, G Kontzoglou, K Karagiannidis
More informationNeurological Assessment Part 1
Neurological Assessment Part 1 MOTOR EXAMINATION: Look at bulk, contour and symmetry of individual muscles: muscles of face upper arm arm thigh lower leg Look for atrophy--may help to localize the site
More informationInformed Consent Botulina Toxins Botox, Dysport, Xeomin Neurotoxins
Informed Consent Botulina Toxins - Botox Neurotoxins Informed Consent Botulina Toxins Botox, Dysport, Xeomin Neurotoxins INSTRUCTIONS This is an informed-consent document that has been prepared to help
More informationCHAPTER 17 FACIAL AESTHETIC SURGERY. Christopher C. Surek, DO and Mohammed S. Alghoul, MD. I. BROW LIFT (Figures 1 and 2)
CHAPTER 17 FACIAL AESTHETIC SURGERY Christopher C. Surek, DO and Mohammed S. Alghoul, MD I. BROW LIFT (Figures 1 and 2) A. Open Coronal Brow Lift Technique 1. Coronal incision is made in the hair-bearing
More informationBOTOX (onabotulinumtoxina) for Therapeutic Use
BOTOX (onabotulinumtoxina) for Therapeutic Use BOTOX (onabotulinumtoxina) & BOTOX Cosmetic (onabotulinumtoxina) Important Information IMPORTANT SAFETY INFORMATION BOTOX and BOTOX Cosmetic may cause serious
More informationInformed Consent Form
Informed Consent Form Botox Cosmetic (onabotulinumtoxin A) Dysport (abobotulinumtoxin A) Xeomin (incobotulinumtoxin A) INSTRUCTIONS This is an informed-consent document that has been prepared to help inform
More informationAndy was treated for frown lines and crow s feet. Results may vary. Please see Important Safety Information, including Boxed Warning, inside.
Andy was treated for frown lines and crow s feet. Results may vary. Please see Important Safety Information, including Boxed Warning, inside. Feel confident that you can still look like yourself With BOTOX
More informationFERN Pattern technique
FERN Pattern technique Dynamic solution (dynamic folds and wrinkles) Depth: mid-dermis Angle: 90º angle from fold Location: from fold (wrinkle) Wrinkle see skin stiffness changing as you injecct after
More informationcally, a distinct superior crease of the forehead marks this spot. The hairline and
4 Forehead The anatomical boundaries of the forehead unit are the natural hairline (in patients without alopecia), the zygomatic arch, the lower border of the eyebrows, and the nasal root (Fig. 4.1). The
More informationAnatomy & Physiology B. Chapter 6: Muscles
Anatomy & Physiology B Chapter 6: Muscles Warm-up What are the three types of muscle tissue? Where are each located? Which are voluntary and which are involuntary? Which are striated which are unstriated?
More informationSince botulinum toxin type A was approved by the
Treating the lower face and neck with neuromodulators: benefits and complications Abstract This article is will educate practitioners on the possibilities that botulinum toxin type A can offer their patients,
More informationThe Role of Muscles in Movement
The Role of Muscles in Movement Muscles can t push, they can only pull as they contract, so most often body movements are the result of the activity of pairs or teams of muscles acting together or against
More informationALTERNATIVE TREATMENTS
Botox Consent INSTRUCTIONS This is an informed- consent document which has been prepared to help your plastic surgeon inform you concerning BOTOX (Botulina Toxin Type A, Allergan) injection, its risks,
More informationBones Ethmoid bone Inferior nasal concha Lacrimal bone Maxilla Nasal bone Palatine bone Vomer Zygomatic bone Mandible
splanchnocranium - Consists of part of skull that is derived from branchial arches - The facial bones are the bones of the anterior and lower human skull Bones Ethmoid bone Inferior nasal concha Lacrimal
More informationWARNING: DISTANT SPREAD OF TOXIN EFFECT
Dear Doctor, We have enclosed a sample XEOMIN (incobotulinumtoxina) treatment patient consent form for your information. Please be aware that this form is merely intended for use as an example. Merz Aesthetics,
More information200 SW 8 th St, STE A, Ocala, FL PH: FAX: Dr. Omar Garcia, Medical Director
200 SW 8 th St, STE A, Ocala, FL 34471 PH: 352-369-0104 FAX: 352-369-0107 Dr. Omar Garcia, Medical Director BRIEF MEDICAL HISTORY Name Phone Age Height Weight Address City State Zip Current Physician's
More informationBotulinum Toxin
Botulinum Toxin Botulinum toxin type A injections are one of the most popular minimally-invasive cosmetic procedures performed to treat facial lines and wrinkles, called frown lines, on the forehead. Botulinum
More informationBone Practical. Labs Muscle Labs. Final Practical. Divisions of the Muscular System. Quiz format
Bone Practical Labs 17 + 18 Muscles Wed 7/11 @ 8am 40 50 stations About half axial, half appendicular bones Disarticulated bones: Skulls, partial skulls, vertebrae, ribs, skeletons, arm bones, leg bones,
More informationBuilding a Global Neurotoxin Franchise
JUNE 2, 2014 Building a Global Neurotoxin Franchise DAN BROWNE President & CEO Forward-Looking Statements This presentation contains forward-looking statements, including statements related to the process
More informationPlease see Important Safety Information, including Boxed Warning, inside.
Sandra was treated in her frown lines and crow s feet areas. Results may vary. Please see Important Safety Information, including Boxed Warning, inside. Approved Uses BOTOX Cosmetic (onabotulinumtoxina)
More informationVertical relation: It is the amount of separation between the maxilla and
Vertical relations Vertical relation: It is the amount of separation between the maxilla and the mandible in a frontal plane. Vertical dimension: It is the distance between two selected points, one on
More informationIt is now widely recognized that there is a critical. Dental Facial Aesthetics Aesthetic shaping of the neck/positive side effects on the gingiva
Dental Facial Aesthetics Aesthetic shaping of the neck/positive side effects on the gingiva Warren Roberts, DMD This article discusses the relationship between Platysma, a large muscle of the face and
More informationBotulinum Toxin A: A Review of 1,085 Oral and Maxillofacial Patient Treatments
J Oral Maxillofac Surg 61:317-324, 2003 Botulinum Toxin A: A Review of 1,085 Oral and Maxillofacial Patient Treatments Joseph Niamtu III, DDS* Purpose: Botulinum toxin A (Botox; Allergan, Inc, Irvine,
More informationCynthia was treated for her frown lines and crow s feet. Results may vary. Please see Important Safety Information, including Boxed Warning, inside.
Cynthia was treated for her frown lines and crow s feet. Results may vary. Please see Important Safety Information, including Boxed Warning, inside. Your lines don t define you Get the subtle results you
More informationPRODUCT MONOGRAPH. abobotulinumtoxina for injection, Ph. Eur. Sterile lyophilized powder for solution for injection. 300 Units per vial
PRODUCT MONOGRAPH Pr DYSPORT AESTHETIC abobotulinumtoxina for injection, Ph. Eur. Sterile lyophilized powder for solution for injection 300 Units per vial Neuromuscular Blocking Agent Manufactured by:
More informationA Patient s Guide to Aesthetic Treatments
A Patient s Guide to Aesthetic Treatments See Important Safety Considerations on Slides 28-30 2009 Medicis Aesthetics Inc. RES 09-106 10/30/10 What happens as we age? Hyaluronic acid (HA) is a naturally
More informationPrinciples of Facial Reconstruction After Mohs Surgery
Objectives Principles of Facial Reconstruction After Mohs Surgery Identify important functional anatomy and aesthetic units of the face. Describe techniques used in facial reconstruction. Discuss postoperative
More informationCM01 Facelift. Copyright 2007 Page 1 of 6
CM01 Facelift What is a facelift? A facelift is an operation to tighten and lift the soft tissues of your face and neck. Your surgeon will assess you and let you know if a facelift is suitable for you.
More informationSEE IMPORTANT SAFETY INFORMATION ON PAGE 2. See Important Safety Information inside.
See Important Safety Information inside. Visit BotoxCosmetic.com to learn more. By prescription only. 1-800-BOTOX-MD Also from the Allergan family of brands: 2010 Allergan, Inc., Irvine, CA 92612. marks
More informationBotuli focal d THERAPEUTIC INTERVENTION
30 PRACTICAL NEUROLOGY THERAPEUTIC INTERVENTION The Little Milkmaid by Amedeo Modigliani (1884 1920). Does this represent artistic licence or cervical dystonia? Nigel Hyman Department of Neurology, Radcliffe
More informationLATISSE (bimatoprost ophthalmic solution) 0.03% Important Information
LATISSE (bimatoprost ophthalmic solution) 0.03% Important Information Indication LATISSE (bimatoprost ophthalmic solution) 0.03% is indicated to treat hypotrichosis of the eyelashes by increasing their
More informationUpdate on botulinum toxin for facial aesthetics
Dermatol Clin 20 (2002) 1 13 Update on botulinum toxin for facial aesthetics Q1 Q2 Jennifer Clay Cather, MD a,b, *, J. Christian Cather, MD a,b, Alan Menter, MD a,b a Texas Dermatology Research Institute,
More informationSubject Index /6/2018 2:06:06 AM. Downloaded by:
Subject Index Acrosyringium, metal salt interactions 32 34, 40 Aluminum chloride hexahydrate antimicrobial effect 40 antiperspirant efficacy in hyperhidrosis 32, 38, 39 application mode 38 clinical indications
More informationTikrit University College of Dentistry Dr.Ban I.S. head & neck anatomy 2 nd y.
Lec [3]/The scalp The scalp extends from the supraorbital margins anteriorly to the nuchal lines at the back of the skull and down to the temporal lines at the sides. The forehead, from eyebrows to hairline,
More informationINFORMED CONSENT BOTOX INJECTION
. Purchasers of the Patient Consultation Resource Book are given a limited license to modify documents contained herein and reproduce the modified version for use in the Purchaser's own practice only.
More informationDYSPORT (Clostridium botulinum type A toxin-haemagglutinin complex)
DYSPORT (Clostridium botulinum type A toxin-haemagglutinin complex) CONSUMER MEDICINE INFORMATION What is in this leaflet This leaflet answers some common questions about Dysport. It does not contain all
More informationAn infected insect bite? Dr Estée Török Honorary Consultant in Infectious Diseases & Microbiology Addenbrooke s Hospital, Cambridge
An infected insect bite? Dr Estée Török Honorary Consultant in Infectious Diseases & Microbiology Addenbrooke s Hospital, Cambridge Case history 48 year old man Presented to A&E with 48 hour history double
More informationINTRODUCTION: ANATOMY UNDERLYING CLINICAL TESTS OF CRANIAL NERVES
INTRODUCTION: ANATOMY UNDERLYING CLINICAL TESTS OF CRANIAL NERVES CRANIAL NERVE I - OLFACTORY I - OLFACTORY NERVE - SMELL TEST: SMELL ODORS (note: not ammonia; pain in nasal cavity CN5 DAMAGE: LOSS OF
More informationbe very thin and variable. Facial nerve branches that exit the parotid gland are deep to the SMAS.
The Superficial musculoaponeurotic system (SMAS) fascia is a fanlike fascia that envelops the face and provides a suspensory sheet which distributes forces of facial expression.. The SMAS is continuous
More informationPlease see Important Safety Information, including Boxed Warning, inside.
Sandra was treated in her frown lines and crow s feet areas. Results may vary. Please see Important Safety Information, including Boxed Warning, inside. Approved Uses BOTOX Cosmetic (onabotulinumtoxina)
More informationYou know you want to. Ask us today. Please see Important Safety Information, including Boxed Warning, inside.
You know you want to Ask us today. Please see Important Safety Information inside. 2016 Allergan. All rights reserved. All trademarks are the property of their respective owners. BotoxCosmetic.com 1-800-BOTOXMD
More informationFace and Scalp 解剖學科鄭授德
Face and Scalp 解剖學科鄭授德 本教材之圖片取自於 1 Gray s Anatomy for Students, 3rd ed, 2015, by Drake, Vogl, and Mitchell 2 Clinically Oriented Anatomy, 7th ed, 2014, by Moore, Dalley, and Agur 3 Clinically Oriented
More informationHIGHLIGHTS OF PRESCRIBING INFORMATION
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use JEUVEAU safely and effectively. See full prescribing information for JEUVEAU. JEUVEAU (prabotulinumtoxina-xvfs)
More informationDYSPORT (Clostridium botulinum type A toxin-haemagglutinin complex)
DYSPORT (Clostridium botulinum type A toxin-haemagglutinin complex) CONSUMER MEDICINE INFORMATION What is in this leaflet This leaflet answers some common questions about Dysport. It does not contain all
More informationPRODUCT MONOGRAPH. abobotulinumtoxina for injection Ph. Eur. Sterile lyophilized powder for solution for injection. 300 Units per vial
PRODUCT MONOGRAPH Pr DYSPORT AESTHETIC abobotulinumtoxina for injection Ph. Eur. Sterile lyophilized powder for solution for injection 300 Units per vial Neuromuscular Blocking Agent Manufactured by: Ipsen
More informationBotox for Chronic Migraine: Tips and Tricks
Botox for Chronic Migraine: Tips and Tricks Ten Questions for Andrew M. Blumenfeld, MD Andrew M. Blumenfeld is director of The Headache Center of Southern California. Most of his research has focused on
More informationImportant Safety Information
Important Safety Information What is the most important information you should know about Oysport? Spread of Toxin Effects: In some cases, the effects of Dysport and all botulinum toxin products may affect
More informationThere have been studies made to quantify the amount of fat in the neck; it appears that the volumetric changes associated with the neck is an
There have been studies made to quantify the amount of fat in the neck; it appears that the volumetric changes associated with the neck is an interplay of the subplatysmal and pre-platysmal fat pads. INJECTABLES
More informationOur Experience with Endoscopic Brow Lifts
Aesth. Plast. Surg. 24:90 96, 2000 DOI: 10.1007/s002660010017 2000 Springer-Verlag New York Inc. Our Experience with Endoscopic Brow Lifts Ozan Sozer, M.D., and Thomas M. Biggs, M.D. İstanbul, Turkey and
More informationThe FIRST and ONLY FDA-APPROVED botulinum toxin for the treatment of LOWER LIMB SPASTICITY in pediatric patients 2 years of age and older 1.
The FIRST and ONLY FDA-APPROVED botulinum toxin for the treatment of LOWER LIMB SPASTICITY in pediatric patients years of age and older 5 Steps to dosing and dilution with Indication is indicated for the
More informationRehabilitation of the Paralyzed Face
Rehabilitation of the Paralyzed Face Elizabeth J. Rosen, MD Faculty Advisor: Karen H. Calhoun, MD The University of Texas Medical Branch Department of Otolaryngology Grand Rounds Presentation October 30,
More informationTreatment of facial palsy with Botulinum Toxin (Botox) Information for patients
Treatment of facial palsy with Botulinum Toxin (Botox) Information for patients page 2 of 8 You have been recommended treatment with Botulinum Toxin. This leaflet aims to explain the treatment, what to
More informationDYSPORT for Injection (abobotulinumtoxina) Initial U.S. Approval: April 2009
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use DYSPORT for Injection safely and effectively. See full prescribing information for DYSPORT for Injection.
More informationPRODUCT MONOGRAPH. incobotulinumtoxina. Clostridium Botulinum Neurotoxin Type A (150 kd), free from complexing proteins
PRODUCT MONOGRAPH Pr XEOMIN COSMETIC TM incobotulinumtoxina Clostridium Botulinum Neurotoxin Type A (150 kd), free from complexing proteins Powder for solution for injection 100 units per vial Pharmaceutical
More informationMuscles Built on the Maniken
Muscles Built on the Maniken Facial Muscle Group 1. Temporalis O temporal fossa I anterior border of the ramus of the mandible A elevates the mandible (bite muscle) and holds jaw while at rest 2. Procerus
More informationBlepharospasm: 1.25 Units-2.5 Units into each of 3 sites per affected eye (2.6) Strabismus: 1.25 Units-2.5 Units initially in any one muscle (2.
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use safely and effectively. See full prescribing information for. (onabotulinumtoxina) Initial U.S. Approval:
More informationLab Activity 11: Group I
Lab Activity 11: Group I Muscles Martini Chapter 11 Portland Community College BI 231 Origin and Insertion Origin: The place where the fixed end attaches to a bone, cartilage, or connective tissue. Insertion:
More informationThe Muscular System PART C. PowerPoint Lecture Slide Presentation by Patty Bostwick-Taylor, Florence-Darlington Technical College
PowerPoint Lecture Slide Presentation by Patty Bostwick-Taylor, Florence-Darlington Technical College The Muscular System 6 PART C Five Golden Rules of Skeletal Muscle Activity Table 6.2 Muscles and Body
More informationComplications in Fillers and Botox
Complications in Fillers and Botox Joseph Niamtu III, DMD KEYWORDS Botox Injectable fillers Botox complications Filler complications Injectable filler complications Minimally invasive cosmetic facial surgery
More informationXEOMIN (incobotulinumtoxina) for injection, for intramuscular use Initial U.S. Approval: 2010
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use safely and effectively. See full prescribing information for. (incobotulinumtoxina) for injection,
More informationXEOMIN (incobotulinumtoxina) for injection, for intramuscular or intraglandular use Initial U.S. Approval: 2010
HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use safely and effectively. See full prescribing information for. (incobotulinumtoxina) for injection,
More information